June 25, 2013
DAL: DRS-NH 13-01
Unsafe Wandering – High Risk Season
Dear Administrator:
Please remind your staff to be especially diligent in preventing unsafe wandering behavior.
It is recommended that a review be conducted of your facility’s wandering behavior management
program. The program should promote time for outside activities that can be therapeutic and
helpful to the resident’s health status and quality of life, while also including mechanisms that
reduce the risk of unsafe behaviors and adverse outcomes that can result.
In order to better familiarize yourself and staff with your facility’s wandering/elopement policies
and procedures, please re-examine your security systems to ensure that adequate safeguards are
in place. Special attention should be given to the following:
o The desire of residents to spend time outside.
o Changes in resident health or mental status. Ensure residents are reassessed for risk
of unsafe wandering behavior when any significant change in status occurs and
modify the resident’s care plan accordingly.
o Assignment of staff (as a result of increased staff vacations) who are not familiar with
all residents and their special needs.
o Increased number of visitors who are unfamiliar with facility procedures/operations
and residents. Staff who monitor building egress locations should be especially
vigilant during times of the day when visitor traffic is high.
o Weather related conditions that might impact alarms or other environmental features
of the facility.
o Functionality of door and wander alarm alerts (including all bracelets). Please ensure
that all alarms are functioning and that they are tested frequently.
It is important that your facility remains attentive to prevent negative resident outcomes
associated with unsafe wandering. ALL staff should be aware of the facility’s systems, policies
and procedures for identifying, managing, preventing, and responding to unsafe behaviors.
Additionally, to ensure ongoing resident safety, leadership should communicate with staff when
back-up systems are implemented due to non-functioning, primary alarm systems. Please
consider posting this letter at all nursing stations, staff rooms and security areas.
The Department acknowledges and appreciates the progress made in the effectiveness of
managing residents with wandering behaviors. We encourage your efforts to provide our
residents with a safe environment that allows them to enjoy a meaningful and satisfying quality
of life. If you have any questions, please contact my office at (518) 408-1267.
Sincerely,
Jacqueline Pappalardi, Director
Division of Nursing Home and
ICF/IID Surveillance
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